多发性骨髓瘤克隆起源的研究  

THE CLONAL ORIGIN OF MULTIPLE MYELOMA

作　　者：王颖[1] 武淑兰[1] 薛海鹏[1] 曹香红[1] 刘淑俊[1] 孙可淳[1] 

机构地区：[1]北京医科大学第一医院血液学研究室,北京市肿瘤防治研究所,北京医科大学第一医院医学统计室

出　　处：《中华内科杂志》1995年第10期663-665,共3页Chinese Journal of Internal Medicine

基　　金：国家自然科学基金

摘　　要：为了解外周血中肿瘤克隆细胞的分化阶段，进一步研究ＭＭ（多发性骨髓瘤）发病机理，采用针对Ｂ细胞不同分化阶段抗原ＣＤ１０、ＣＤ１９、ＣＤ２０、ＣＤ４５ＲＡ、ＣＤ４５ＲＯ、ＣＤ３８的单克隆抗体，用ＡＰＡＡＰ法（碱性磷酸酶抗碱性磷酸酶法）同时检测１７例外周血中不含浆细胞的ＭＭ患者骨髓及外周血的免疫表型，其中１０例外周血表达浆细胞抗原增高（Ｐ＜０．００１）且与骨髓一致。９例外周血表达ＣＤ３８和ＣＤ４５ＲＯ，３例表达ＣＤ３８、ＣＤ４５ＲＡ、ＣＤ４５ＲＯ，１例表达ＣＤ３８、ＣＤ４５ＲＡ、ＣＤ４５ＲＡ和ＣＤ１０。此结果显示ＭＭ患者外周血的Ｂ系抗原表达既与骨髓具有一致性，又具多样性，提示ＭＭ的外周血中存在多分化阶段的肿瘤前体细胞，呈现自早期Ｂ细胞，经活化Ｂ细胞及晚期Ｂ细胞向前浆细胞的持续分化过程，并验证了文献关于ＭＭ发病途径的推测。n order to explore the clonal origin and malignant pathway of multiple myeloma (MM),a study has been made to investigate the differentiation stage of malignant progenitor cells in peripheral blood (PB)of MM. The immnophenotype of mononuclear cells(MC)in PB and bone marrow (BM) from 17 patients with MM were studied with APAAP method by using monoclonal antibodies directed to a series of B-cell markers(CD10,CD19,CD20,CD45RO,CD45RO,CD38).There were no plasma cells in samples of PB examined.Out of the 17 patients,MC of PB from 10 expressed plasma cell antigen CD38.This expression was significantly different from normal control(P<0.001)and identical with that of BM. MC of 9 pa- tients were CD38￣+ and CD45RO￣+,3 were CD38￣-、CD45RO￣- and CD45RA￣+ and 1 was CD38￣-、CD4 5RA￣+、CD45RO￣+ and CD10￣+ in PB. The results indicate that while the B-cell marker’s expression of PB matches with that of BM,its forms are diversified. This suggests that the PB of MM patients contains precursors at multiple differentiation stages of myeloma cells,from early B cell to active B cell、late B cell and preplastna cell. MC of PB from 10 patients expressed CD45RO while that of BM from 5 out of them expressed the same. This indicates that preplasrna cells which are CD45RO￣+ in PB may eventually return to BM for homing and differentiating into plasma cells,thus losing CD45RO and expressing CD38 only. This study has proved the presence of malignant cells in PB of MM,confirmed the speculation of the ma- lignant pattern and provided the theoretical basis for purging of PB in autologous peripheral blood stem celltransplantation.

关 键 词：免疫表型 骨髓肿瘤 单克隆抗体 B细胞 抗原 

分 类 号：R733.302[医药卫生—肿瘤] R446.62[医药卫生—临床医学]